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bettyboops

MAINTENANCE DOSE OF ACCUTANE

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Hi guys, besides the Odom article and Plewig article on low dose accutane, i am trying to find material to bring in to my doctor on maintenance doses.

THinking particularly of 20mg 2X week, or 10mg two or 3 times a week. The above are good articles, but I am wanting to bring more than two articles on this idea of low dose maintenance, long term, to show my dermatologist.

Oh by the way, if anyone else is interested in the above articles I'll post the links. The latest thinking for older folk is that lower is good, especially in the case of rosacea component of acne.

Thanks for any help pointing me towards more articles!!!

Betts

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Hi guys, besides the Odom article and Plewig article on low dose accutane, i am trying to find material to bring in to my doctor on maintenance doses. 

THinking particularly of 20mg 2X week, or 10mg two or 3 times a week. The above are good articles, but I am wanting to bring more than two articles on this idea of low dose maintenance, long term, to show my dermatologist.

Oh by the way, if anyone else is interested in the above articles I'll post the links.  The latest thinking for older folk is that lower is good, especially in the case of rosacea component of acne.

Thanks for any help pointing me towards more articles!!!

Betts

Doesn't anyone??? doubt.gif

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Hi guys, besides the Odom article and Plewig article on low dose accutane, i am trying to find material to bring in to my doctor on maintenance doses.

THinking particularly of 20mg 2X week, or 10mg two or 3 times a week. The above are good articles, but I am wanting to bring more than two articles on this idea of low dose maintenance, long term, to show my dermatologist.

Oh by the way, if anyone else is interested in the above articles I'll post the links. The latest thinking for older folk is that lower is good, especially in the case of rosacea component of acne.

Thanks for any help pointing me towards more articles!!!

Hey Betts

Apologies that I cannot contribute here !! eusa_doh.gif

But I have been seeing some cases in other logs that prolonging the use of Accutane actually has more severe persisting effects stating that " people on maintenanace dosage", even though really low gives bad headaches, higher cholesterol level and other stuffs which derm hates to give maintenance dosage... redface.gif

I don't know how true is it but perhaps I could find out from my derm next Mon when I visit him for my monthly visit...

Old Zit /Chris

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Hey, i'm sorry, i can't help you.

I'm on a low dose of accutane (20 mg/day) for a long time.

Can you post the links to those articles you've read.

I dont have rosacea yet (says my derm), but i have a red face, and dry eyes, so maybe its the beginning.

The accutane doesnt seem to affect it much though.

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Hey, i'm sorry, i can't help you.

I'm on a low dose of accutane (20 mg/day) for a long time.

Can you post the links to those articles you've read.

I dont have rosacea yet (says my derm), but i have a red face, and dry eyes, so maybe its the beginning.

The accutane doesnt seem to affect it much though.

here's one: http://www.dermatologytimes.com/dermatolog...il.jsp?id=65528

I am still looking for the Odom article again as well. I must remember to immediately save these to favorites!!!

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Hi betty

Just read that link - very interesting! I might print it and take it with my on my next appointment. (Do doc's generally hate it when you bring info?)

I have my derm appointment in about 3 weeks and I'm definately going to go for it cos I'm not improving at all on these antibiotics. Still worried about that initial flare up - but way I see it, life is one long continous flare at the moment anyway - so what have I got to lose?

Hope you're doing well.

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i'd like to find the reaction when you give that to your derm.........i may do it myself when my derm appointment comes up

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i'd like to find the reaction when you give that to your derm.........i may do it myself when my derm appointment comes up

Here is my thinking on this. If the derm is a good derm, they like info, because that is their field, and they need to keep abreast of studies and publications. I always bring in my research, and it is appreciated. I think I would be concerned if it were not appreciated!!

You guys have luck with the Odom article? I am visiting and traveling and will be checking in...hope to have time to post that link. GOOD study.

Hope everyone is having a super weekend!!

Hugs from the Kais

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Odom article?

Here's one:

http://rosacea.ii.net/hl/11537.html

And here's an interesting, newish, paper regarding Accutane efficiency in general.

http://www.fda.gov/ohrms/dockets/ac/00/bac.../3639b1d_01.pdf

It discusses a new formulation of Accutane (NF) compared to the old one (AC). One of the observations: normal doses of Accutane might be too high & the lowest effective dose hasn't been established.

C.

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Hi, sorry I can't help either. But I do have an interest in low dose therapy. I do well with seven days on 40mg and three weeks off. Right now I'm on mino. What's worse, full time mino or part time tane? I'm going to ask my doc next visit. I'll be watching for your answers from your docs. Thanks.

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Hi, sorry I can't help either. But I do have an interest in low dose therapy. I do well with seven days on 40mg and three weeks off. Right now I'm on mino. What's worse, full time mino or part time tane? I'm going to ask my doc next visit. I'll be watching for your answers from your docs. Thanks.

Hi TJ, I think mino might be worse. In fact, I developed a lupoid condition, as I was on mino almost 18 years...I definitely want a maintenance tane dose, as this is working again as it did so many years ago...

Cloudy, thank you so much for these articles. I want all I can get for my next appointment. Maybe it's not new to my derm but it sure is new to me, the idea of a maintenance dose....

Thanks so much!!!!

Betts

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More about isotretinoin dosing from the 59th meeting of the American Academy of Dermatology

Isotretinoin: Dosing, Safety, and a New Formulation

Barbara A. Burrall, MD  

Alternative Isotretinoin Dosing

Typical dosing guidelines for isotretinoin are:

Full dose: 0.5-2 mg/kg per day for 15-20 weeks

Initial dose should be no more than 0.5 mg/kg per day

Only rarely is a dose of 2 mg/kg per day required. In addition, doses of 0.1-0.5 mg/kg per day are also effective in clearing severe acne. However, in a standard 20-week course, when these doses were compared with 1 mg/kg per day, it was found that recurrence was twice as frequent when the lower doses were employed. Therefore, in a standard 20-week course, the 1 mg/kg per day dose is preferred.

In Europe, the daily dose is thought to be less important than the total dose. As long as a total dose of 120-150 mg/kg was reached, recurrence was not greater with the lower daily doses. Of course, the treatment course must be longer to achieve the appropriate final total doses if lower daily doses are used. This could mean greater risk of pregnancy in women of child-bearing potential.

In the past, the full 1 mg/kg per day dose was started initially, but most clinicians now advocate beginning therapy with a reduced dose of no more than 0.5 mg/kg per day, and frequently even as low as 10-20 mg per day for at least the first 3 weeks. Starting slowly helps prevent the occasional severe flare that may accompany abrupt full-dose onset. Dr. Shalita begins counting the 20-week course only after he has reached the full 1 mg/kg dose.

When a severe inflammatory reaction does occur, one must stop the isotretinoin and start prednisone (40-60 mg per day) along with an antibiotic. As the reaction cools, isotretinoin may be restarted at a very low dose, such as 10 mg every other day, and increased very gradually as the prednisone is tapered. Similarly, for severe, acute inflammatory conditions such as pyoderma faciale or rosacea fulminans, antibiotics and prednisone are initiated with low-dose isotretinoin added slowly.

http://www.medscape.com/viewarticle/418879

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Hi Beetyboops, mino for 18 years. wow. What's a lupoid condition?

My gp doesn't seem to want to send me back to the derm. He says he feels mino can be weaned to a maintenance dose of 25mg a day. I find that hard to believe but I'm at his mercey for now. Thanks for the info. Take care

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Hi and thanks all!

I wonder, Tane, what good mino will do at 25mg...! How are you doing??

Thanks cloudy, for the info, am going to read this now.

Porad, good idea, I searched a while back on that and will resume. I was frustrated by lack of full text articles and maybe my parameters were too strict.

All feedback welcome...thanks again.

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Hi and thanks all!

I wonder, Tane, what good mino will do at 25mg...!  How are you doing??

Thanks cloudy, for the info, am going to read this now.

Porad, good idea, I searched a while back on that and will resume. I was frustrated by lack of full text articles and maybe my parameters were too strict.

All feedback welcome...thanks again.

Oh, also - the lupoid condition - ANA shot up to 1:640, speckled. Could have meant lupus; SLE and other related conditions.

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Hi Betty, I don't know what effect 25mgs will have as I have not cut myself to that. The last prescription was 50 times twice a day for a week and then 50mgs once a day after that. I'm still doing the 100 a day for a bit then I will try and cut to 50 a day. Let you know how it goes but so far it seems I need the 100 for any effect.

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Now here is news.

There is something on the market called Oracea which is supposed to be a good maintenance option.

It is submicrobial and does not have the side effect of stripping good flora from our systems.

Regards,

Betts

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Now here is news. 

There is something on the market called Oracea which is supposed to be a good maintenance option. 

It is submicrobial and does not have the side effect of stripping good flora from our systems.

Regards,

Betts

Think tha Oracea is a form of doxy ??

But doxy did not do any good to my acne ...

Old Zit

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Yeah, I know sad.gif and after awhile Minocycline didn't work on me...but evidently this is better than minocin for maintaining!

How I hope everyone is doing well.....

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Yeah, I know sad.gif  and after awhile Minocycline didn't work on me...but evidently this is better than minocin for maintaining!

How I hope everyone is doing well.....

So Betts

What is the chance of a maintenance daosage on Accutane that is considered safe ?? eusa_doh.gif

Geez, I guess most derms are quite reluctant on putting people on tane.. geez is there a cure out there with like minimum side effects and get rid of those irritating zits ??

eusa_think.gif

Anyway, I am doing quite alrite, I think I am 70 % there.. but still on like 30 mg per day and my derm says it is ok and probably put me there for another month, not sure if I want to ask him to up my dosage for longer remission ??

Chris aka Old Zit

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